October 18, 2001

House Committee Meets In Memphis To Discuss State's Nursing Home Issues

Several area witnesses painted a problematic picture regarding the future of the nursing home industry for members of the House Select Committee on Nursing Home Care, which met at the Memphis Theatre October 15.

Representatives from several local care centers spoke to the 10-panel committee chaired by First District State Representative Sam Berkowitz. They discussed several troubling issues including declining revenue, deficit Medicaid reimbursement, shrink-ing labor force and growing governmental regulations.

Richard Dunn of the Department of Health and Senior Services told the committee of the state's 1,200 nursing homes and the likely impact that a growing senior citizen population will have on the industry. He noted there are currently as many as 21,000 empty beds in nursing homes and residential care facilities in the state.

"That creates a false sense of security as we will be pressed for services as the growing senior population arrives," Dunn stated.

Currently Missouri is home to 950,000 seniors. Dunn stated this number will more than double to two million seniors in the next three or four years. Currently seven percent of the senior population is in nursing homes. To meet these estimated numbers in the future, either the number of nursing home beds must rise or the percentage of seniors residing in nursing homes must drop to four percent.

In addition to the growing senior population, Dunn also pointed to a need for change in the industry, which is still often based on a 30-year old model.

"We must help our industry become better," Dunn said. "Thirty years ago we began to see the evolution of nursing home services when Medicaid really kicked in. At that time the services were predominantly provided to those who weren't really sick. These programs worked then, but now we must consider higher levels of care and specialized services for the greater needs of a growing number of patients."

Dunn explained the shift in care provided by nursing homes over this period, noting that a large number of residents in nursing homes likely would have been patients at hospitals 30 years ago and not in a residential care facility.

"Residents are living longer which poses greater challenges to meet all the needs of the patients," Dunn said. "The old model was not designed to accommodate the special needs and high medical service require-ments that we are seeing."

Now the service provided by nursing homes of old is being provided at home through home health care agencies. Now most residents are not entering nursing homes until they are forced to for medical reasons.

"We can't destroy the system, we simply must make it better," Dunn said. "We must introduce new techniques for new seniors that are going to be needing care in the future. We definitely have gained the ability to prolong life. Now we must be able to prolong the quality of life as well."

Carol Rodriguez testified to the committee regarding the biggest increasing specialization of care area, Alzheimer's Disease. She informed the committee members of the 100,000 Missourians that suffer from the disease. The numbers reach four million in the United States and are expected to grow to 14 million in the recent future.

Rodriguez stated the dramatic increase can be traced to the figures presented by Dunn regarding the rapidly increasing seniors population. She said that half of the nation's population over the age of 85 suffer from some form of dementia.

Alzheimer's Disease creates a large problem for the nursing home industry because of the nature of the illness. The average Alzheimer's patient lives for eight years after diagnosis with many living as much as 20 years.

Rodriguez also pointed out the growing cost of serving these residents. The average expense is $174,000 per individual.

She also pointed to home care issues, indicating as many as 70 percent of Alzheimer's patients are cared for at home, at least in the early stages of the disease. She noted that in-home health care, adult daycare and respite care can delay nursing home placement by an average of 300 days.

The number one issue created by the growing Alzheimer's problem is staffing said Rodriguez. There is a growing need for nursing career professionals that are appropriately trained to do the very difficult tasks involved with the disease she noted.

Rodriguez noted that Certified Nursing Assistants (CNAs) is the fastest growing national employment field. However the average national compensation level for CNAs is just $7.56. That compares to an average salary of $8.74 in retailed sales and more than $10 for unskilled factory employees.

Another trouble area noted by Rodriguez was the Medicaid guidelines, specifically the qualifying level that disqualifies anyone with cash assets of more than $1,000. She noted this figure had not been changed in more than 30 years.

Rodriguez gave the committee two recommendations. First, to maintain and maximize the in-home family care option for Alzheimer's patients. Secondly, she suggested the committee make every effort to sustain affordable medical care options for both citizens and the state.

Barbara Primm, of the Lockhead Care Facility in Macon told the committee the quality of care is a direct result of having adequate numbers of well-trained staff. She noted that the number and type of staff need to be related to care needs not just the number of patients.

Primm also addressed the state's quality control measures. She noted the state's survey process is often adversarial. She questioned why the survey process does not scrutinize the poorer facilities and leave the good ones alone.

The industry is facing a shortage of nurses that is comparable to what the education field is experiencing with a lack of teachers, Primm told the committee. She suggested making assistance available for education, transportation and childcare needs of prospective nursing employees. Primm also suggested lowering the restriction from 18 to 17 years of age to earn a CNA degree.

Currently CNA training goes on either in the nursing facility or in an area vocational technical school. It requires 75 classroom hours as well as 100 hours of on the job training.

The final main topic of discussion was the declining Medicaid reimbursement numbers for nursing homes. Robert Seamster, administrator of the Schuyler County Nursing Home told the committee that a recent study of care centers across the Midwest noted an average loss of $8.91 per day, per Medicaid patient.

He noted that much of the problem lies in the fact the maximum rates were set in 1995 and were based on 1992 cost reports.

He also cited a price index study that revealed a 22.4 percent increase in the consumer price index between 1984-89. During that same period the medical price index increased by 41.7 percent. Yet Seamster noted the Medicaid rate only increased 13.5 percent over that time frame.

Seamster told the committee that the Medicaid system must be looked at to allow nursing homes at least the ability to break even.

Special Legislative Session to Remedy Issue of Abortion Sanctuary Cities

by Rep. Craig Redmon

This week the House of Representatives is in Jefferson City, answering Governor Greitens’ call for a special session in response to some troubling events of the past few months. In April, a federal judge struck down years of regulations put in place to ensure abortion clinics met a certain standard of health requirements in order to operate in Missouri. In combination with the Abortion Sanctuary City ordinance in St. Louis, it is clear that pro-life Missourians and pregnancy care centers are under attack by abortion advocates from across the state and nation.

In the face of these attacks on pro-life Missourians, Governor Greitens has called a second extraordinary session this summer so we, the General Assembly, can send legislation to his desk to curtail these efforts to undermine our state’s healthcare regulations and to protect the lives of the innocent unborn.

The timing of the judge’s ruling in late April, more than a month after the deadline for new bill submissions, makes this topic wholly worthy of a special session, due to the timing making a full response during the regular session impossible. This session also gives the legislature the opportunity to remedy the issue of Abortion Sanctuary Cities. The Missouri Constitution explicitly gives Governor Greitens the ability to call special sessions of the General Assembly for extraordinary topics. The wiping of abortion regulations and allowing abortion clinics that were closed after failing to meet minimum health and safety standards to resume operation is one such extraordinary topic that requires action.

I am proud to support the health of women. I am proud to stand with the Governor. I am proud to be pro-life.

Last week the Senate passed a bill that would nullify the Sanctuary City ordinance, allow Missouri’s attorney general to prosecute violations of abortion laws, and require annual inspections of abortion clinics. In addition, it creates a set of guidelines requiring certain standards to be met for an abortion clinic to operate. Now the bill moves to the House of Representatives. I was elected as a pro-life legislator to advocate on the side of life, and it is my desire to work with my fellow Representatives to strengthen and pass this legislation in a way to protect Missouri families.

Culvert Replacements Will Temporarily Close Several Routes in Scotland County

HANNIBAL – Weather permitting, MoDOT crews will perform culvert work the below routes in Scotland County.

Work will be done on Route M on June 27, with the road temporarily closed just north of Scotland County Route W for a culvert replacement. The road will be closed from 7:30 a.m. to 4:00 p.m.

Scotland County Route V will be temporarily closed between 1 mile of Scotland County Route M and 2 miles of Route M for a culvert replacement on June 28th The road will be closed from 7:30 a.m. to 4:00 p.m.

Work will be done on Scotland County Route D on June 29, with the road temporarily closed between 3 miles of Missouri Route 15 and 3.1 miles of Route 50 for a culvert replacement. The road will be closed from 7:30 a.m. to 4:00 p.m.

Motorists will need to use alternate routes during these times.

Again, this work is weather dependent and could be rescheduled or delayed. For more information, contact MoDOT’s Customer Service Center toll-free at 1-888-ASK MoDOT (275-6636). All roadwork is posted on the traveler information map. You can also visit us online at www.modot.org/northeast.

Extension Expert Says Delayed Hay Harvest Calls for Testing

This year’s delayed hay harvest calls for hay testing.

University of Missouri Extension agronomy specialist Anthony Ohmes says farmers benefit from routine hay testing.

Hay quality varies based on forage species, maturity, management, harvest conditions, and insect or disease damage. Guessing the quality of hay fed to livestock could result in lower profits, Ohmes says. Knowing the hay’s nutrient value can help livestock owners decide if animals need supplements.

Ohmes suggests that farmers sample each lot separately. A lot comes from the same field and forage makeup, and is grown and harvested under the same environmental conditions. “Every field and cutting will be different,” Ohmes says.

Use a 12- to 24-inch hay probe, he says. It should be 3/8 to 5/8 of an inch in diameter. Do not grab or hand pull samples. Samples collected that way do not provide uniform results and could lead to misleading values.

Sample multiple bales out of a hay lot. The lot should represent at least 10 percent, or at least 15 random bales.

The sampling method varies for each bale type. On large round bales, take samples on the curved side of the bale and remove the outer layer if moldy. Avoid sampling from the outside of the bale. On large square bales, take samples at a 45-degree angle on the side of the bale or 90-degree angle on the end of the bale. Sample small square bales through the center and end.

Keep each lot separate, Ohmes says. Mix samples in a bucket and fill a quart  plastic bag. Samples perish quickly, so send them to the lab on the same day as the sampling. If this is not possible, keep samples away from direct sunlight and store in a cool, dry place until sending. Freeze high-moisture samples (above 15 percent) such as baleage or silage if they cannot be sent right away.

Mark the sample by date, cutting, location and owner before shipping.

Some MU Extension centers lend probes at no cost. Find information on hay sampling at crops.missouri.edu/forage.

Hay tests cost about $20 each at certified labs throughout the state. You can find information on how to read results at extension.missouri.edu/aginfocus/forage-testing.aspx.

Rural Hospital are a Lifeline

by U.S. Congressman Sam Graves

Rural hospitals are a literal lifeline for tens of millions of people across this country. In communities that don’t have enough primary care doctors or health facilities, rural hospitals provide a critical, lifesaving service that otherwise would not be here for us.

Unfortunately, about 80 rural hospitals have closed since 2010. What’s worse, one third of all rural hospitals in the U.S. could close in the next few years. That’s 12 million Americans at risk of losing access to the closest emergency room. A devastating number, and something we can’t allow to continue in rural America.

Cuts to hospital payments have worsened the problem, and as populations decrease in rural communities, so-called “medical desserts” are popping up across rural America. It leaves people living on farms or in small towns dangerously vulnerable to medical emergency – particularly older Americans.

This week, I am joining with my colleague from Iowa, Dave Loebsack, to introduce the Save Rural Hospitals Act. This bipartisan bill looks to reverse the trend of rural hospital closures, in part by eliminating unrealistic federal regulations like the “96 hour rule,” which forces rural hospitals to move a patient within 96 hours in order to get reimbursed by Medicare.

The average rural hospital creates 195 jobs and generates $8.4 million in annual payroll. But more than that, these facilities make communities livable, ensuring a doctor isn’t far away when a medical emergency strikes.

This bill shines a light on the rural health crisis in Missouri and across the country. If we accept this reality – and neglect this much needed conversation – rural hospitals in Missouri will continue to close. This leaves thousands without access to health care, putting lives in jeopardy and affecting every family in Middle America. That’s simply not acceptable.

City Looking to Crack Down on Traffic Violations

Memphis residents are being reminded to monitor posted speed limits. Photo by Maddy Zahn.

With an increasing number of citizens voicing complaints regarding traffic concerns, the Memphis City Council recently agreed to move forward with an increased police presence while also encouraging a lower tolerance level for infractions.

Complaints have centered around speeding, stop sign adherence and non-traditional vehicle usage such as ATVs and golf carts.

“The City of Memphis has not written a lot of traffic tickets, but unfortunately that appears like it is going to have to change,” said Alderman Chris Feeney. “This isn’t about revenue, or being punitive, it is about public safety.”

Police Chief Bill Holland indicated officers have tried to use warnings and have allowed some leeway when dealing with speed enforcement.

Under the new council directive, that tolerance level will be reduced.

“In the past, we may have just flashed our lights at you, or offered a warning when a car was going a little too fast,” said Holland. “Now those cars going 30 in a 20 will likely be looking at a ticket.”

Holland stated the enforcement efforts have been ongoing, with officers performing additional traffic patrols. In an effort to enhance those efforts, a part-time officer has been added to the police force. Justin Allen from Clark County will be joining the MPD, and Holland indicated his initial responsibilities will focus on traffic control. The department has been shorthanded with the departure of officer Jason Ketchum, and Holland said efforts will continue to replace that full-time officer as well.

The council also has discussed the possibility of adding a radar camera system that could be deployed by the department in trouble areas to help deter speeding and produce data on traffic volume and speed habits of motorists.

“We are not turning a deaf ear to citizen complaints,” said Holland. “When we become aware of trouble spots, we increase our presence there, but it takes being in the right spot at exactly the right time to catch the people responsible for the complaints.”

Unless otherwise posted, the speed limit within the city limits is 25 mph. ATV’s, golf carts or utility vehicles are allowed on public streets only by special permit, available at city hall. They may only be driven by licensed drivers and are not to exceed 30 mph regardless if the posted speed limit is higher.

Holland noted that enforcement efforts are difficult with a small force, that typically only has one officer on duty, adding that police presence performing traffic patrol normally turns into a simple deterrent rather quickly as motorists become aware of the law enforcement presence and temporarily reduce speeds or choose alternate routes.

While automated traffic controls such as radar cameras and stop sign video surveillance are not particularly popular with the public, the city council expressed a willingness to at least consider such measures.

“I’m certain I have exceeded a posted speed limit at some time or other,” said Alderman Feeney. “In doing so I could be putting the public safety at risk. So I have a choice, I can either slow down and monitor my speed better, or I can risk paying a ticket.”

The council is hoping the community chooses the first option, but is anticipating it will take more of the later for the initiative to hit home and start to sink in for motorists.

Area Students Named to MU Dean’s List

Several area students were named to the University of Missouri spring semester 2017 dean’s list.

Kathryn Mary Howard of Memphis has been named to honor roll. Howard is a senior student.

Samantha Rachel Tobler, a senior, was named to the 2017 dean’s list for the spring semester.

Jaclyn Wiggins, a junior student in the arts and science school, was named to the honor roll as well.

More Than $988 Million in Unclaimed Property Waiting to be Returned  Statewide

JEFFERSON CITY – State Treasurer Eric Schmitt on June 15th announced the start of an annual effort to return Unclaimed Property to Missourians by publishing the names of owners in Missouri newspapers. Starting June 16, the names of more than 145,000 individuals, families, small businesses, and non-profits with Unclaimed Property will be printed in more than 100 publications across the state.

“Our team works hard every single day to financially empower Missourians by returning the money they are rightfully owed,” Schmitt said. “One in ten Missourians have Unclaimed Property, and this public awareness initiative is one of the many creative ways we work to get abandoned money back to its rightful owners. I encourage all Missourians to visit ShowMeMoney.com to see if they or someone they know has money waiting to be claimed free of charge.”

Missouri law requires these notices be published annually in order to list the names of individuals whose Unclaimed Property valued at $50 or more has been turned over to the State Treasurer’s Office in the past year.

Individuals, families, small businesses, and others can check to see if they have Unclaimed Property on ShowMeMoney.com. They can also sign up for email notifications when new assets come in matching their information and send notifications to family and friends to let them know about money being held in their name.

Treasurer Schmitt has returned more than $13.5 million to over 50,000 account holders since taking office in January. The average Unclaimed Property return is around $300.

Fireworks Season Will Run June 20th – July 10th in City of Memphis

As the Independence Day holiday approaches, the Memphis Police Department is reminding city residents of ordinances related to the discharge of fireworks in city limits.

Fireworks may be discharged from June 20 – July 10th from 8 a.m. to 11 p.m. daily. That coincides with the permitted sales period.

Fireworks are prohibited on public property, including parks and the municipal lakes. It is unlawful for any person to discharge any fireworks within the city limits of Memphis, except upon their own property or upon property whose owner has given his/her consent. It is also illegal to recklessly discharge fireworks in such a manner that the explosion of the same will be likely to endanger or cause injury or damage to any person or property within the city limits of Memphis.

Any person violating any of the provisions of the city’s fireworks ordinance shall, upon conviction, be punished by a fine not exceeding $500 or by imprisonment in the City or County Jail not exceeding ninety 90 days, or by both such fine and imprisonment; provided, that in any case wherein the penalty for an offense is fixed by a Statute of the State, the statutory penalty, and no other, shall be imposed for such offense.

Memphis Man Facing Charges Following Motorcycle Crash

A Memphis man is facing numerous charges following a motorcycle crash on Route MM Tuesday evening.

According to the Missouri State Highway Patrol, the accident occurred at 7:30 p.m. on June 13th, a half mile south of the Highway 136  intersection, just south of Memphis.

Russell B Matthew, 34, was southbound on Route MM on a 1993 Suzuki 500 motorcycle when the vehicle ran off the right side of the roadway and overturned. Matthew sustained moderate injuries in the crash. He was transported via patrol car to Scotland County Hospital.

Matthew was ticketed for driving while intoxicated, no valid license, leaving the scene of an accident, child endangerment, failure to wear approved headgear and failure to drive on right half of the roadway.

The Patrol was assisted at the scene by the Memphis Police Department and the Scotland County Sheriff’s Office.

Large Hail Storm Pounds Scotland County

Chrissy Myers put the hail to the ruler test, topping out at two inches in diameter.

Some brief power outages and several downed tree limbs  were all that law enforcement had to report following Saturday’s severe weather that hit northeast Missouri, but the real damage reports started rolling in Monday at local insurance offices.

The National Weather Service reported “Severe thunderstorms tracked across eastern Iowa, northeast Missouri, and north central Illinois Saturday afternoon and evening. Large hail, torrential rain, and damaging winds up to 65 mph were reported.  Very large hail fell in Muscatine, IA and Antioch, MO, where golf ball and baseball size hail was reported respectively.”

The heavy rains and high winds did minimal damage in Scotland County, but hail ranging in size from golf ball to as big as baseballs, was reported, leading to hundreds of claims for hail damage to vehicles, homes and businesses.

Local insurance agents and auto body repair specialists indicated it is too early to offer a  solid estimate for storm damages, but several speculated that with anywhere from 300 to 500 damaged vehicles and a smaller number of hail damaged homes and businesses, the total could easily eclipse $1 million.

At approximately 7:15 p.m. Saturday evening, the frozen precipitation hit the City of Memphis. Trained storm spotters reported hail up to two-inches in diameter, with reports and photos of larger bundles of ice making their rounds via social media.

Kris Lister collected this assortment of hail stones at his Memphis residence on Mi-Lor Street.

The storm continued east, with similar damage reports out of Kahoka and Clark County around 7:45 p.m.

More than 2 inches of rain was reported during the storm, with the hail dissipating as the storm left Missouri, but still resulting in significant rainfall in southeast Iowa and eastern Illinois.

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